Combined Efficacy of Global Longitudinal Strain and Epicardial Fat Thickness Measurement in Assessing Coronary Artery Disease Severity

Abstract

Context: More positive global longitudinal strain (GLS) and higher epicardial fat thickness (EFT) correlate with coronary artery disease (CAD) severity. Aim: The aim of the study was to assess the combined efficacy of GLS and EFT measurement in predicting severity of CAD measured by coronary angiography. Study and Design: Prospective, observational study conducted in Government Medical College, Kottayam, Kerala, for 2 years. One thousand patients with ≥50% coronary stenosis were grouped as cases and 500 patients who had normal coronaries or <50% stenosis were taken as controls. Subjects and Methods: EFT and GLS were measured by transthoracic echo and the severity of CAD was by Gensini scoring. Statistical Analysis Used: Mean and standard deviation used for quantitative data and group differences were compared with Student’s t-test. Results: We observed a mean EFT of 7.2 mm ± 1.6 mm and mean GLS of–13.24 ± 1.6 among cases compared to a mean EFT of 3.4 mm ± 0.8 mm and mean GLS of–19.2 ± 1.2 in the controls with P < 0.001. The cutoff values of EFT and GLS for predicting significant CAD were 4.85 mm and 14.9 with a sensitivity of 96% and specificity of 88%. Conclusion: Combined use of GLS and EFT measurement is less costly and very well correlates with CAD severity.

Keywords

• epicardial fat
• global longitudinal strain
• gensini score